A cardiac stress test evaluates how the heart handles physical activity or simulated exertion. It helps physicians determine how well blood flows through the heart muscle and assess the heart’s electrical activity under stress. Total appointment time ranges from about 60 minutes for a standard exercise electrocardiogram (ECG) to three or four hours for more complex imaging procedures. This variability depends on the specific type of test ordered, but the active physical portion is consistently brief.
Preparing for the Appointment
Preparation typically takes 20 to 30 minutes, allowing time for check-in, reviewing medical history, and changing into a gown. A technician prepares the chest area to ensure strong electrical contact for the monitoring equipment. This preparation often involves lightly rubbing the skin with an abrasive material or shaving small patches of hair.
The technician attaches about ten sticky patches, known as electrodes, to specific points on the chest. Wires connect these electrodes to an ECG machine, which records the heart’s electrical signals. A blood pressure cuff is secured to the arm for continuous monitoring. These steps establish baseline readings of heart rate, blood pressure, and resting ECG for comparison during the active phase.
The Active Testing Phase
The active testing phase is the shortest part of the appointment, usually lasting only 8 to 12 minutes for an exercise stress test. The goal is not endurance but to safely increase the heart rate to a predetermined level.
The exercise often follows a standardized protocol, such as the Bruce protocol, which divides the activity into successive three-minute stages. The treadmill’s speed and incline are incrementally increased at the start of each stage to raise the heart’s workload. The test stops once the patient reaches their target heart rate, typically 85% of the maximum predicted heart rate (calculated as 220 minus the patient’s age).
If a patient cannot exercise due to physical limitations, a pharmacological or chemical stress test is performed instead. Medication is delivered intravenously to simulate exertion by making the heart pump faster. The active infusion typically lasts 10 to 20 minutes. In either case, the medical team closely monitors the ECG, blood pressure, and patient symptoms throughout this high-intensity phase.
Post-Procedure Monitoring
Once the active testing phase is complete, the patient transitions into the recovery period. The patient rests while remaining connected to the monitoring equipment. This period ensures stability and allows the medical team to record how quickly heart rate and blood pressure return to resting levels.
Post-procedure monitoring typically lasts 10 to 15 minutes, until vital signs return to near-baseline measurements. The swiftness of heart rate recovery is an important diagnostic metric regarding the nervous system’s control over heart function. Once the medical staff is satisfied with the patient’s stability, the electrodes and blood pressure cuff are removed, and the patient is cleared to leave.
Why the Total Time Varies
The total appointment time varies based on the inclusion of advanced imaging techniques. A standard exercise ECG stress test, which only records the heart’s electrical activity, is the quickest, often completed in about 60 minutes from check-in to discharge. However, many diagnostic protocols require imaging to provide a clearer view of blood flow and muscle function.
Stress Echocardiogram
A Stress Echocardiogram adds ultrasound imaging, requiring the technician to capture images before exercise and a second set immediately after the patient stops. This process, followed by standard recovery monitoring, often extends the total appointment time to 60 to 90 minutes, or up to two hours.
Nuclear Stress Test
This test requires the injection of a radioactive tracer to visualize blood flow. The protocol involves an initial imaging scan while resting, followed by the active stress phase, and then a second set of images after exercise. The total process, including time for the tracer to circulate and for the separate imaging scans, can extend the appointment length to three or four hours.